title: Incidence of surgical-site infection is not affected by method of immediate breast reconstruction.
abstract: BACKGROUND
  To date, few large-scale studies have reported the incidence of surgical-site infection in women undergoing mastectomy with respect to the various methods of immediate breast reconstruction. This study assessed whether the reconstruction method was associated with the risk of surgical-site infection in these patients.
  
  
  METHODS
  Using the National Surgical Quality Improvement Program database, 9230 female patients undergoing mastectomy with immediate reconstruction from 2005 to 2009 were identified. Reconstruction was classified as autologous, prosthetic, or hybrid. The primary outcome was the incidence of surgical-site infection within 30 days of operation. Univariate and multivariate analyses were performed to derive the unadjusted and adjusted risk of surgical-site infection according to reconstruction method.
  
  
  RESULTS
  The overall rate of surgical-site infection was 3.53 percent (95 percent CI, 3.15 to 3.94 percent), with individual rates of 3.33 percent (95 percent CI, 2.93 to 3.76 percent) for prosthetic reconstruction, 4.88 percent (95 percent CI, 3.48 to 6.11 percent) for autologous reconstruction, and 2.19 percent (95 percent CI, 0.88 to 4.45 percent) for hybrid reconstruction. The adjusted odds ratio of surgical-site infection was 1.14 (95 percent CI, 0.83 to 1.58; p = 0.42) for autologous versus prosthetic methods and 0.59 (95 percent CI, 0.27 to 1.27; p = 0.18) for hybrid versus prosthetic methods.
  
  
  CONCLUSIONS
  Although the risk of surgical-site infection in patients undergoing immediate reconstruction is highest with autologous and lowest with hybrid methods of reconstruction, the difference in infection risk was not statistically significant after adjustment for confounding factors. Thus, all methods of reconstruction are viable options with regard to risk for surgical-site infection.
  
  
  METHODS
  Risk, III.
authors.affiliation: Los Angeles, Calif. From the Division of Plastic and Reconstructive Surgery and the Department of Surgery, Keck School of Medicine, University of Southern California.
authors.forename: Melinda A
authors.initials: MA
authors.lastname: Costa
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rommer
authors.forename: Mirna
authors.initials: M
authors.lastname: Peric
authors.forename: T JoAnna
authors.initials: TJ
authors.lastname: Nguyen
authors.forename: Ahva
authors.initials: A
authors.lastname: Shahabi
authors.forename: Gabrielle B
authors.initials: GB
authors.lastname: Davis
authors.forename: Evan N
authors.initials: EN
authors.lastname: Vidar
authors.forename: Linda S
authors.initials: LS
authors.lastname: Chan
authors.forename: Alex K
authors.initials: AK
authors.lastname: Wong
mesh_terms: D018427:Breast Implants; D001943:Breast Neoplasms / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016462:Mammaplasty / Q000009:adverse effects* / Q000379:methods*; D008408:Mastectomy; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology; D013997:Time Factors; D014481:United States / Q000453:epidemiology